Small intestinal bacterial overgrowth (SIBO)
| Def: 108– 1010/ ml organism
Symptoms: BPD
- Bloating, Pain, Distension, Diarrhea
|
Treatment:
- Treatment of underlying causes
- eg- surgical repair of intestinal stricture
- Antibiotics
- A course of broad spectrum antibiotic for 2-4 weeks
- non absorbable: Rifaximin
- systemic: cipro, metro, amoxicillin
- Continuous rotating course of antibiotics may be needed
- Supportive treatment
- Nutritional support
- Correction of anemia
- Probiotics
- Correction of micronutrient – IM vit B12
- Motility disorder- diabetes, systemic sclerosis
- Antidiarrheal – loperamide, diphenoxylate
- Hypogammaglobulinemia – For giardiasis
- Metro/ tinidazole
- Immunoglobulin infusion
|
Causes: (SHIM)
- Hypochlorhydria
- impaired Motility
- Structural abnormalities
- impaired Immune function
|
Investigation
- CBC, PBF
- Serum albumin
- Endoscopic jejunal aspiration with culture– gold standard
- Hydrogen breath test
- Barium follow through X ray
- Biochemical
- Vit B12- reduced
- S electrolytes, Ca, Mg
|
